Value Assessement Of Multidisciplinary Treatment On Diagnosis,Treatment And Prognosis Of Locally Advanced Rectal Cancer

ObjectiveTo evaluate the effect of the Multidisciplinary Treatment Team(MDT)on the diagnosis and treatment plan and prognosis of locally advanced rectal cancer(LARC)patients,and evaluate its application value in the diagnosis and treatment of locally advanced rectal cancer patients.MethodsWe collected clinical data of 30 patients with locally advanced rectal cancer who received MDT treatment(MDT group)and 75 patients(control group)who did not receive MDT treatment during the same period from January 2016 to December 2018 from the First Affiliated Hospital of Zhengzhou University for retrospective analysis.The extracted basic data of patients included gender,age,complications,CEA,clinical stage,tumor location,treatment plan,pathological type,degree of tissue differentiation,presence of nerve invasion,vascular cancer embolism,depth of local invasion,local lymph node metastasis,distant metastasis,etc.The measurement data were analyzed by two independent samples t-test or Mann-Whitney U test,and the statistical data were compared by χ2 test or Fisher’s exact probability method.K-M survival analysis was used to compare the survival difference between the two groups,to explore the effect of MDT on the treatment process and outcome of the two groups and its application value in locally advanced rectal cancer.ResultsA total of 105 cases were collected,including 21 males and 9 females in MDT group.The mean age was 57.5 years old.The control group had 45 males and 30 females.The mean age was 57.1 years old.There were no statistically significant differences in gender,age,complications,CEA,clinical N stage and tumor location between the two groups(P>0.05),but the preoperative T stage T4 ratio in MDT group was 8 cases/22 cases,which was higher than that in control group(6 cases/69 cases,P<0.05).Compared with the control group,patients in MDT group had a higher rate of receiving preoperative neoadjuvant chemotherapy and radiotherapy(90%vs61%,respectively,P<0.05).40%vs8%,P<0.001).There was no significant difference between the two groups in the choice of open surgery,laparoscopic surgery and robotic surgery(P>0.05).Comparison of surgical data between the two groups showed no statistically significant differences in length of postoperative hospital stay,anastomotic fistula,dysuria,pathological types,vascular cancer emboli,number of metastatic lymph nodes,number of dissected lymph nodes,distance from distal resection margin,postoperative radiotherapy and chemotherapy(all P>0.05).The degree of differentiation in MDT group was lower than that in control group(P<0.05),and the proportion of nerve invasion in MDT group was higher than that in control group(P<0.05).In terms of the anal preservation rate of low rectal cancer(the distance between the lower edge of the tumor and the anal edge<5cm),the MDT group was higher than the control group(P<0.05).There was no statistical significance in the 2-year local recurrence rate and 2-year distant metastasis rate between the two groups(P>0.05).There was no statistical significance in the overall survival curve and progression-free survival curve between the two groups(P>0.05).ConclusionMDT cooperative diagnosis and treatment mode can make the treatment of locally advanced rectal cancer patients more standardized,may improve the anal preservation rate of patients with low rectal cancer,and then improve the quality of life of patients.Whether it can improve the survival of patients needs to be further explored in further studies.